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Objective: To describe the operative findings and surgical results of unilateral congenital middle ear malformations with intact external ear.Methods: A retrospective review was performed on 64 patients with unilateral congenital middle ear malformations and intact external ear who underwent exploratory tympanotomy from 2011 to 2016. Demographic data, clinical data, high-resolution computed tomography findings, audiometric data and intraoperative findings were collected. Audiological evaluations before and 6 months after surgery were analyzed in 47 patients.Results: The most common malformation were mobile stapes with missing incus long process and stapes suprastructure. The air conduction pure tone average was 58.9 ± 10.5 dB HL (range 34.4-78.1 dB HL) preoperatively and 28.8 ± 10.6 dB HL (range 9.4-55.6 dB HL) postoperatively (P = 0.000). Twenty-five cases (53.2%) acquired an air conduction hearing gain exceeding 30 dB. Mean air-bone gap (ABG) was 44.5 ± 9.4 dB (range 22.5-66.4 dB HL) before surgery and 15.6 ± 9.3 dB (range 0-35.6 dB) after surgery (P = 0.000) for an average gain of 28.8 ± 11.5 dB. Thirty-four cases (72.3%) showed a postoperative ABG of less than 20 dB, 15 had an ABG within 10 dB, and 4 had 0 dB ABG after operation. No significant difference was observed for air conduction hearing gain regarding age (P = 0.261) or types of malformations (mobile stapes footplate with or without a suprastructure anomaly, P = 0.058).Conclusion: Unilateral congenital middle ear malformations with intact external ear can be complex and diverse. Functional ossiculoplasty for patients with unilateral congenital middle ear malformations can achieve good hearing outcomes. [ABSTRACT FROM AUTHOR]

In this paper, an overall framework has been presented for person verification using ear biometric which uses tunable filter bank as local feature extractor. The tunable filter bank, based on a half-band polynomial of 14th order, extracts distinct features from ear images maintaining its frequency selectivity property. To advocate the applicability of tunable filter bank on ear biometrics, recognition test has been performed on available constrained databases like AMI, WPUT, IITD and unconstrained database like UERC. Experiments have been conducted applying tunable filter based feature extractor on subparts of the ear. Empirical experiments have been conducted with four and six subdivisions of the ear image. Analyzing the experimental results, it has been found that tunable filter moderately succeeds to distinguish ear features at par with the state-of-the-art features used for ear recognition. Accuracies of 70.58%, 67.01%, 81.98%, and 57.75% have been achieved on AMI, WPUT, IITD, and UERC databases through considering Canberra Distance as underlying measure of separation. The performances indicate that tunable filter is a candidate for recognizing human from ear images. [ABSTRACT FROM AUTHOR]

Comparative auditory studies make it possible both to understand the origins of modern ears and the factors underlying the similarities and differences in their performance. After all lineages of land vertebrates had independently evolved tympanic middle ears in the early Mesozoic era, the subsequent tens of millions of years led to the hearing organ of lizards, birds, and mammals becoming larger and their upper frequency limits higher. In extant species, lizard papillae remained relatively small (<2 mm), but avian papillae attained a maximum length of 11 mm, with the highest frequencies in both groups near 12 kHz. Hearing-organ sizes in modern mammals vary more than tenfold, up to >70 mm (made possible by coiling), as do their upper frequency limits (from 12 to >200 kHz). The auditory organs of the three amniote groups differ characteristically in their cellular structure, but their hearing sensitivity and frequency selectivity within their respective hearing ranges hardly differ. In the immediate primate ancestors of humans, the cochlea became larger and lowered its upper frequency limit. Modern humans show an unusual trend in frequency selectivity as a function of frequency. It is conceivable that the frequency selectivity patterns in humans were influenced in their evolution by the development of speech. [ABSTRACT FROM AUTHOR]

Background: 'Darwin's tubercle' is a term used to describe an atavistic swelling of the posterior helix that is present in some individuals. Little is known about its prevalence, characteristics, and function. With growing interest in the individuality of external ear patterns and its possible applications to personal identification, more knowledge about this tubercle is warranted. Purpose: We review the history, clinical presentation, and modern-day influences of Darwin's tubercle. Method: A comprehensive review of the literature was performed. Pubmed was searched with the key words: auricle, congenital, Darwin, ear, evolution, helix, pinna, tubercle, Woolnerian. Result: Darwin's tubercle has been documented to be present in about 10.5% of the Spanish adult population, 40% of Indian adults, and 58% of Swedish school children. It has a variety of clinical presentations, which may be classified by its degree of protuberance. The influence of genetics on the expression of Darwin's tubercle is unclear, and there are conflicting observations about its correlations with age and gender. Although usually present bilaterally in individuals who do possess this trait, a portion of this population does display asymmetric expression. Conclusion: Darwin's tubercle is a benign and unique helical feature. It contributes to the individuality of human ears and may have applications toward personal identification in the future. [ABSTRACT FROM AUTHOR]

The detection of sound begins when energy derived from an acoustic stimulus deflects the hair bundles on top of hair cells. As hair bundles move, the viscous friction between stereocilia and the surrounding liquid poses a fundamental physical challenge to the ear's high sensitivity and sharp frequency selectivity. Part of the solution to this problem lies in the active process that uses energy for frequency-selective sound amplification. Here we demonstrate that a complementary part of the solution involves the fluid-structure interaction between the liquid within the hair bundle and the stereocilia. Using force measurement on a dynamically scaled model, finite-element analysis, analytical estimation of hydrodynamic forces, stochastic simulation and high-resolution interferometric measurement of hair bundles, we characterize the origin and magnitude of the forces between individual stereocilia during small hair-bundle deflections. We find that the close apposition of stereocilia effectively immobilizes the liquid between them, which reduces the drag and suppresses the relative squeezing but not the sliding mode of stereociliary motion. The obliquely oriented tip links couple the mechanotransduction channels to this least dissipative coherent mode, whereas the elastic horizontal top connectors that stabilize the structure further reduce the drag. As measured from the distortion products associated with channel gating at physiological stimulation amplitudes of tens of nanometres, the balance of viscous and elastic forces in a hair bundle permits a relative mode of motion between adjacent stereocilia that encompasses only a fraction of a nanometre. A combination of high-resolution experiments and detailed numerical modelling of fluid-structure interactions reveals the physical principles behind the basic structural features of hair bundles and shows quantitatively how these organelles are adapted to the needs of sensitive mechanotransduction. [ABSTRACT FROM AUTHOR]

Sepsis is associated with impairment in autonomic regulatory function. This work investigates the application of heart rate and photoplethysmogram (PPG) waveform variability analysis in differentiating two categories of sepsis, namely systemic inflammatory response syndrome (SIRS) and severe sepsis. Electrocardiogram-derived heart period (RRi) and PPG waveforms, measured from fingertips (Fin-PPG) and earlobes (Ear-PPG), of Emergency Department sepsis patients ( n = 28) with different disease severity, were analysed by spectral technique, and were compared to control subjects ( n = 10) in supine and 80° head-up tilted positions. Analysis of covariance (ANCOVA) was applied to adjust for the confounding factor of age. Low-frequency (LF, 0.04-0.15 Hz), mid-frequency (MF, 0.09-0.15 Hz) and high-frequency (HF, 0.15-0.60 Hz) powers were computed. The normalised MF power in Ear-PPG (MFnu) was significantly reduced in severe sepsis patients with hyperlactataemia (lactate > 2 mmol/l), compared to SIRS patients ( P < 0.05). Moreover, in a group of normal controls, MFnu was not altered by head-up tilting ( P > 0.05), suggesting that there may be a link between 0.1 Hz ear blood flow oscillation and tissue metabolic changes in sepsis, in addition to autonomic factors. The study highlighted the value of PPG spectral analysis in the non-invasive assessment of peripheral vascular regulation in sepsis patients, with potential implications in monitoring the progression of sepsis. [ABSTRACT FROM AUTHOR]

Copyright of Deutsche Zeitschrift für Akupunktur is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Most ENT surgeons treat discharging ears with topical antibiotics but many may not routinely utilise ear microbiology specimens. One reason could be that ear microbiology reports may not reflect their usual therapeutic options. This paper explores how microbiology departments in England process ear swabs. We carried out a telephone questionnaire of 104 microbiology departments in England. Results were obtained from 95 hospitals. Various culture methods are used, with sensitivity testing for up to 51 different antibiotics. Only five are licensed for topical use. Systemic antibiotics seemed to be preferentially tested for over topical antibiotics. Anaerobes and fungus are routinely tested. Many microbiology departments do not routinely report on all sensitivities tested. Antibiotic sensitivity testing for various micro-organisms cultured from ear swabs seemed to be guided by protocols for systemic infections. Microbiologists may not fully appreciate ENT surgeons’ preferential usage of topical antibiotics in treating discharging ears, albeit there are other factors in their consideration for antibiotics to test. To gain better guidance from swab results, and to reduce needless lab costs, discussion with the microbiologists may be of benefit. [ABSTRACT FROM AUTHOR]

Copyright of Deutsche Zeitschrift für Akupunktur is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pneumatic otoscopy is most helpful for optimally assessing the presence of a middle ear effusion (MEE). To evaluate the diagnostic usefulness and to obtain objective parameters of video pneumatic otoscope (VPO) in ears with MEE, we measured the minimal and maximal pressures in the external auditory canal and recorded the movement of the tympanic membrane (TM) during VPO in 28 ears with MEE and 13 healthy ears. The movements of the TM at static stage, positive and negative pressure stages of VPO were analyzed in terms of the position of the umbo and the angle and length of the malleus. The percent volume of air space out of the total tympanomastoid air cell system (the air index) was obtained from the temporal bone CT, and was used as a reference standard. As a result, minimal pressure and the movement of the umbo from negative pressure stage in ears with MEE were significantly different from the normal ears. The minimal pressure, maximal pressure and the movement of umbo from negative pressure to static stage were significantly correlated with the air index. These results may suggest useful parameters for quantitative analysis of VPO for the visual diagnosis of MEE. [ABSTRACT FROM AUTHOR]

In an experiment on ten rabbits, 8 W carbon dioxide (CO(2)) laser evaporation of the perichondrium, together with one-third to one-half of the thickness of the auricle cartilage, was performed. Subsequently, the auricle was bent in the middle of the vaporized area, the corresponding surfaces of which were then apposed and fixed to each other with mattress sutures. Three months later the auricle specimen was harvested for histopathological evaluation. This revealed that the partially laser-ablated cartilage had grown together in the form of a solid cartilaginous column. The regeneration process, originating from chondroblasts as well as from perichondrium cells, was strongly stimulated by the laser energy delivered. [ABSTRACT FROM AUTHOR]

Copyright of Deutsche Zeitschrift für Akupunktur is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A total of 260 male subjects between 1 and 80 years of age of north-west region of India were studied with regard to morphometry of the ear lobule. The purpose of the present study was to obtain average values and range of measurements of several parameters of the ear lobule and the differences between right and left lobules. Female subjects were excluded from the study due to piercing. Various measurements of lobule were taken with the help of Vernier and Lange's calipers. The results of the aforementioned measurements were analyzed statistically using Student's t-test. The maximum length of the lobule increased appreciably between 6–15 years and 41–80 years. The breadth of the ear lobule increased up to the age of 15 years and was almost static between the ages of 16 and 40 years and increased again from 41 years onwards. Length of the lobule showed significant growth from the age group of 6–10 to 11–15, 21–40 to 41–60 and 41–60 to 61–80 years on the right side and 6–10 to 11–15 and 21–40 to 41–60 years on the left side. Breadth and thickness of ear lobule also showed statistically significant growth pattern in some age groups. On comparing the ear lobe dimensions with the studies available in other populations of the world, it was observed that north-west Indians have smaller ear lobules as compared to Caucasian and Japanese populations. In the present study, the frequency of attached (square) type of lobules was the maximum, followed by free (pendulous) type and tapering lobules. These findings were similar to those found among the Onge tribe of Andhra (India) and Newars of Nepal. [ABSTRACT FROM AUTHOR]

In this study, we aimed to assess anatomical relationship between the anterior inferior cerebellar artery (AICA) and cochleovestibular nerve (CNV) in patients with non-specific cochleovestibular symptoms using magnetic resonance imaging (MRI). One-hundred and forty patients with non-specific neuro-otologic symptoms were assessed using cranial and temporal MRI. Classification was performed according to four different types of anatomical relationship observed between the AICA and CVN. In type 1 (point compression), the AICA compresses only a limited portion of the CVN. In type 2 (longitudinal compression), the AICA approaches the CVN as both traverse parallel to each other. In type 3 (loop compression), the vascular loop of the AICA encircles the CVN. In type 4 (indentation), the AICA compresses the CVN so as to make an indentation in the nerve. The anatomical relationship between the CVN and AICA was encountered in 19 out of 140 (13.6%) patients (20 ears). The VCC was unilateral in 18 patients (94.7%) and bilateral in one patient (5.3%). There was no other vascular structure causing VCC to the CVN except for vertebral artery that was seen in 2 out of 140 patients (1.4%). These were unilateral cases. There were tinnitus, vertigo or dizziness, hearing loss, and both hearing loss and vertigo in 5 (25%), 13 (65%), 1 (5%) and 1 (5%) ears of 20 patients, respectively. There was no relationship between the cochleovestibular symptoms and type of compression ( p>0.05). Neurovascular relationship between the CVN and AICA can be imaged properly using MR and MR based classification may help reporting this relationship in a standard way. Although, MR images can show the anatomical relationship accurately, diagnosis of vascular conflict should not be based on imaging findings alone. [ABSTRACT FROM AUTHOR]

In self-rotation reproduction tasks, subjects appear to estimate the displacement angle and then reproduce this angle without necessarily replicating the entire temporal velocity profile. In contrast, subjects appear to reproduce the entire temporal velocity profile during linear motion stimulating the otoliths. To investigate what happens during combined rotation and translation, we investigated in darkness the central processing of vestibular cues during eccentric rotation. Controlling a centrifuge with a joystick, nine healthy subjects were asked to reproduce the angle of the previously imposed rotation. Rotations were either ON-center, or 50 cm OFF-center with inter-aural centripetal acceleration. Rotation duration was either variable (proportional to the traveled angle), or constant. We examined whether the stimulation of the otoliths during OFF-center rotation changes self-rotation reproduction, and whether rotation duration is processed differently by the nervous system with and without otolith stimulation. As postulated, the subjects indeed reproduced more closely the stimulus velocity profile when OFF-center. But the primary result is that the additional supra-threshold linear acceleration cues, measured by the otoliths, did not improve performance. More specifically, to our surprise, the ability to reproduce rotation angle degraded slightly in the presence of additional information from the otolith organs, with the linear acceleration cues appearing to interfere with the reproduction of movement duration. [ABSTRACT FROM AUTHOR]

Von Oort first described the vestibulocochlear anastomosis in 1918, and there have been very few anatomical studies of it. It is located at the bottom of the internal auditory meatus and links the saccular nerve to the cochlear nerve. The aim of this study was to investigate the micro-anatomical characteristics of this anastomosis. We dissected 10 human temporal bones from five heads. We found the vestibulocochlear anastomosis in seven of the specimens, of which six were clearly visible. We were unable to uncover it in three specimens due to dissection problems. Its length was evaluated to be between 0.5 and 1 mm, with a diameter of 0.5 mm. The vestibulocochlear anastomosis could be the pathway for the nerve fibers of the cochlear efferent system, whose description remains incomplete. However, no anatomist, histologist or physiologist has demonstrated this function. From the results of this study, it seems likely that the vestibulocochlear anastomosis exists. Other studies are necessary to link it to the efferent system. [ABSTRACT FROM AUTHOR]

Initial analysis of interaural temporal disparities (ITDs), a cue for sound localization, occurs in the superior olivary complex. The medial superior olive (MSO) receives excitatory input from the left and right cochlear nuclei. Its neurons are believed to be coincidence detectors, discharging when input arrives simultaneously from the two sides. Many current psychophysical models assume a strict version of coincidence, in which neurons of the MSO cross correlate their left and right inputs. However, there have been few tests of this assumption. Here we examine data derived from two earlier studies of the MSO and compare the responses to the output of a computational model. We find that the MSO is not an ideal cross correlator. Ideal cross correlation implies a strict relationship between the precision of phase-locking of the inputs and the range of ITDs to which a neuron responds. This relationship does not appear to be met. Instead, the modeling implies that a neuron responds over a wider range of ITDs than expected from the inferred precision of phase-locking of the inputs. The responses are more consistent with a scheme in which the neuron can also be activated by the input from one side alone. Such activation degrades the tuning of neurons in the MSO to ITDs. [ABSTRACT FROM AUTHOR]

The praying mantis, Mantis religiosa, is unique in possessing a single, tympanal auditory organ located in the ventral midline of its body between the metathoracic coxae. The ear is in a deep groove and consists of two tympana facing each other and backed by large air sacs. Neural transduction takes place in a structure at the anterior end of the groove. This tympanal organ contains 32 chordotonal sensilla organized into three groups, two of which are 180° out of line with the one attaching directly to the tympanum. Innervation is provided by Nerve root 7 from the metathoracic ganglion. Cobalt backfills show that the auditory neuropile is a series of finger-like projections terminating ipsilaterally near the midline, primarily near DC III and SMC. The auditory neuropile thus differs from the pattern common to all other insects previously studied. [ABSTRACT FROM AUTHOR]

The objectives of this study were to evaluate noise levels generated during micro-suction aural toilet using an anatomic silicon ear model. It is an experimental study. In an anatomic ear model made of silicone, the eardrum was replaced by a 1-cm diameter microphone of a calibrated sound-level measuring device. Ear wax was removed using the sucker of a standard ENT treatment unit (Atmos Servant 5). Mean and peak sound levels during the suction procedure were recorded with suckers of various diameters (Fergusson-Frazier 2.7-4 mm as well as Rosen 1.4-2.5 mm). Average noise levels during normal suction in a distance of 1 cm in front of the eardrum ranged between 97 and 103.5 dB(A) (broadband noise). Peak noise levels reached 118 dB(A). During partial obstruction of the sucker by cerumen or dermal flakes, peak noise levels reached 146 dB(A). Peak noise levels observed during the so-called clarinet phenomena were independent of the diameter or type of suckers used. Although micro-suction aural toilet is regarded as an established, widespread and usually safe method to clean the external auditory canal, some caution seems advisable. The performance of long-lasting suction periods straight in front of the eardrum without sound-protecting earwax between sucker and eardrum should be avoided. In particular, when clarinet phenomena are occurring (as described above), the suction procedure should be aborted immediately. In the presence of dermal flakes blocking the auditory canal, cleaning with micro-forceps or other non-suctioning instruments might represent a reasonable alternative. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including dental implants; ear anatomy and Maxillofacial disharmonies.

Variations in the branching pattern of the common, external, and internal carotid arteries can present as arteriovenous malformations, and their basis can be explained embryologically. Our case was a rare variation presenting as a congenital, very gradually increasing bluish painless swelling at the region of the left lobule of the ear arising from an abnormal vessel (from the postauricular artery) which was explored under general anesthesia through a postauricular curved incision. The abnormal vessel and other feeding vessels were ligated and a sclerosing agent injected. Anomalies of pharyngeal arch arteries like our case can be found resulting from the persistence of channels that normally disappear, and prior knowledge of these anomalies is essential before surgeries like mastoidectomy to prevent alarming hemorrhage. [ABSTRACT FROM AUTHOR]

The article presents a correction for a relatively rare congenital ear deformity aptly named "question mark ear." The authors appropriately describe the defect as a deficiency of tissue at the junction of the ear lobe and helical rim and adjacent, resulting in a partial cleft associated with varying degrees of protrusion of the ear itself. In the single case described, the authors used a technique of elevating a posterior subcutaneous skin flap based laterally over a free graft of cartilage from the underlying concha to restore helical rim continuity. With this technique, the flap is rolled up to cover the grafted cartilage, and the skin flap donor site is closed.

Discusses research being done on the role of homeobox Six1 genes in the auditory system. Reference to study by Zheng and colleagues, published in the journal "Development"; Development of the inner ear; Influence of Six1 on cell proliferation during otic development.